Indigent care costs have hit $1 million at McDuffie Regional Medical Center in Thomson during the past year.

"This is the highest it's been since I've been here," said Douglas Keir, administrator and chief executive officer of the hospital. "The cost burden of indigent care has become astronomical and a negative to our hospital budget."

It's a growing concern -- one just as big a problem for smaller hospitals as larger ones.

"Indigent care costs are getting worse by the year," Mr. Keir said during a recent interview.

Every year since 1991 when Mr. Keir came to the hospital, he has sought funding help for some of the indigent care costs from the McDuffie County Board of Commissioners.

But every year, such requests have been rejected. Commissioners contend they have no money appropriated for such requests.

Recently, Mr. Keir asked commissioners for $500,000.

"We're hopeful that with two new commissioners on board that they will see our plight on indigent care costs and see fit to help us some," Mr. Keir said. "We really do need some help, because this is a huge burden on our hospital."

In 1991, indigent care costs were $200,000 at the hospital.

"The number of patients who fall under federal poverty guidelines is growing," Mr. Keir said. "Regardless of the ability of patients to pay for medical treatment, we still have an obligation to treat them."

The reason for such obligation is based on the 1948 Hill Burton Act, Mr. Keir explained.

When the hospital was built, federal funds were used and as a result, the hospital can't turn down patients simply because they are unable to pay.

"We're going to treat you regardless of whether you have or don't have," Mr. Keir said.